@layout("/common/_form.html",{js:["/assets/modular/system/btyBxda/btyBxda_edit_ghs.js"]}){
<style>
    .btnshop {
        display: inline-block;
        height: 38px;
        line-height: 38px;
        padding: 0 18px;
        background-color: #009688;
        color: #fff;
        white-space: nowrap;
        text-align: center;
        font-size: 14px;
        border: none;
        border-radius: 2px;
        cursor: pointer;
        margin-bottom: 10px;
    }
    a:hover {
        color: #FFFFFF;
    }
</style>
<form class="layui-form" id="noticeForm" lay-filter="noticeForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">供货商信息维护</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="roleId" type="hidden"/>
                    <input name="id" id="id" value="${id}" type="hidden"/>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">店名</label>
                        <div class="layui-input-block">
                            <select name="dm" lay-filter="language" id="dm" lay-search="" disabled>
                                <option value=''>全部</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">姓名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input name="xm" placeholder="请输入姓名" type="text" class="layui-input" lay-verify="required"  required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">身份证号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input name="sfz" placeholder="请输入身份证号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">开户行<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input name="khh" id="khh" placeholder="请输入开户行" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">银行卡号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input name="yhk" id="yhk" placeholder="请输入银行卡号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">开户行联行行号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input name="bz" id="bz" placeholder="请输入行号" type="text" class="layui-input"/>

                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <div style="margin-left: 30px;color: red">
                            录入说明：<br>
                        1、录入银行卡号后，点击按钮"识别行号"，自动获取开户行联行行号。<br>
                        2、如果开户行联行行号没有自动获取，请点击 <a class="layui-btn layui-btn-xs" href="http://www.lianhanghao.com/" target="_blank">查询行号</a> 去网站http://www.lianhanghao.com/进行查询
                            <br>3、如果在网站上查询不到，请联系所在银行！
                        </div>

                    </div>

                </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <a class="btnshop" id="btnExp">识别行号</a>
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>保存</button>
    </div>
</form>

@}
